C-reactive protein levels, blood pressure and the risks of gestational hypertensive complications: The Generation R Study
OBJECTIVES: Aim of this study was to investigate the associations of C-reactive protein levels, as marker of low-grade inflammation, with blood pressure development during pregnancy and the risks of gestational hypertensive complications. We also explored the role of maternal BMI in these associations. METHODS: High-sensitivity C-reactive protein levels were measured in early pregnancy (median 13.2 weeks, 95% range 9.6-17.6) in 5816 mothers participating in a population-based prospective cohort study in the Netherlands. Blood pressure measurements were performed in each trimester. Information about pregnancy-induced hypertension and preeclampsia was retrieved from hospital charts of the women. RESULTS: Longitudinal analyses showed that C-reactive protein levels were not associated with SBP and DBP patterns throughout pregnancy. Trimester-specific multivariate linear regression models showed that as compared to low C-reactive protein levels (<5.0 mg/l), elevated levels (≥20.0 mg/l) were associated with maternal SBP and DBP. Elevated C-reactive protein levels in early pregnancy were associated with the risks of pregnancy-induced hypertension [odds ratio (OR) 2.78, 95% confidence interval (CI) 1.66-4.66]. After adjustment for maternal BMI, all associations attenuated. CONCLUSION: Our results suggest that first-trimester C-reactive protein levels are associated with SBP and DBP levels throughout pregnancy and with gestational hypertensive complications, but these associations are largely explained by maternal BMI.
|Keywords||Blood pressure, C-reactive protein, preeclampsia, pregnancyinduced hypertension|
|Persistent URL||dx.doi.org/10.1097/HJH.0b013e32834c58e5, hdl.handle.net/1765/33729|
de Jonge, L.L., Steegers, E.A.P., Ernst, G.D.S., Lindemans, J., Russcher, H., Hofman, A., & Jaddoe, V.W.V-K.. (2011). C-reactive protein levels, blood pressure and the risks of gestational hypertensive complications: The Generation R Study. Journal of Hypertension, 29(12), 2413–2421. doi:10.1097/HJH.0b013e32834c58e5